DSM-V Gender Experts Anger LGBTs
Trans Groups Oppose Psychologists’ Background in Reparative Therapy
© Kat Long
May 15, 2008
The American Psychiatric Association’s appointees for the Sexual and Gender Identity Disorders working group, tasked with updating the diagnosis of Gender Identity Disorder (GID) in the Diagnostic and Statistical Manual V, have angered the transgender community in the U.S. and Canada.
Several (though not all) of the experts have backgrounds in the extremely controversial “reparation therapy” movement, which promotes curing homosexuality or gender nonconformity through psychiatric treatment. LGBT groups uniformly oppose “reparative therapy” (also called “conversion therapy”) and consider it junk science influenced by religious ideology and conservative political propaganda.
Making the DSM-V More Accepting
Some LGBT advocates have called for an overhaul of the diagnosis of Gender Identity Disorder, which they believe pathologizes a natural variant of human sexuality as a mental disorder. The current DSM-IV diagnostic criteria for adults, the industry standard for psychiatry, are:
A. A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex).
B. Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex.
C. The disturbance is not concurrent with a physical intersex condition.
D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
They assert that removing GID from the DSM-V altogether will create a platform for more transgender equality, similar to the removal of homosexuality from the DSM in 1973 and the ensuing growth of the LGBT equality movement. Other advocates fear a declassification of GID would demote the complexities of transgenderism to simple cosmetic issues.
The APA’s Controversial Picks
One issue many transgender and LGB allies agree on is the inappropriateness of the APA’s appointees to the Sexual and Gender Identity Disorders working group.
The chair of the working group, Kenneth J. Zucker, is the Head of the Gender Identity Service in the Child, Youth, and Family Program at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada. American activists may be unfamiliar with Zucker’s history, but Canadians have bitter memories of his advocacy of “reparative therapy.”
CAMH, formerly known as the Clarke Institute (and dubbed “Jurassic Clarke” by its former patients), specializes in treating “those who wish to manage their cross-gender feelings and the expression of those feelings while remaining in their original gender role as well as those questioning their level of adaptation to the cross-dressing or transgendered behavior.” Former patients describe the treatments as “anti-trans” and based on preserving outdated ideas about feminine and masculine gender roles. Zucker, whose work had focused on gender-variant children, has claimed he wants to “help these kids be more content in their biological gender.”
Zucker’s colleague in the APA working group, Ray Blanchard, also works at CAMH as the Head of Clinical Sexology Services. Blanchard has postulated a disorder called “autogynephilia,” which he defines as “a man’s paraphilic [problematic behavior requiring treatment] tendency to be sexually aroused by the thought or image of himself as a woman.” Transgender people refute his attempt to pathologize more variant sexual expressions rather than depathologize them, as new studies about transgenderism’s biological origins emerge. (For a historical view of a transgender man’s role in such scientific development, see Review: The First Man-Made Man).
As head of gender services at CAMH, Blanchard is also responsible for approving transgender patients for sex-reassignment surgery. Many advocates decry his poor rate of admittance. Said Blanchard in a 2004 Globe and Mail article, “This is not waving a magic wand and a man becomes a woman and vice versa. It’s something that has to be taken very seriously. A man without a penis has certain disadvantages in this world, and this is in reality what you're creating.”
Transgender people and allies should applaud one member of the working group--Dr. Jack Drescher, a gay psychiatrist and longtime supporter of psychoanalysis that is more accepting of sexual orientation and gender-variant identities. He is also a vocal opponent of the “reparative therapy” supported by Zucker and Blanchard.
The DSM-V revision will take about four years, and the volume is scheduled for publication in 2012. LGBT activists may have to wait until then to see how far the psychiatric community has come in accepting gender variance as a part of the human sexual spectrum.
Sources:
Patricia Leigh Brown, “Supporting Boys or Girls When the Line Isn’t Clear,” New York Times, December 2, 2006.
Mercedes Allen, "Destigmatization Versus Coverage and Access: The Medical Model of Transsexuality," April 5, 2008, dentedbluemercedes.wordpress.com
Jane Armstrong, "The Body Within, the Body Without," Globe and Mail, June 12, 2004.
Various articles appearing on TSroadmap.com
